'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Letter of the Week: PMS reviews are the wrong place to look for NHS cuts

Here in Darlington the PMS review process began with a direct promise from the PCT negotiators not to cut anything off our baseline.

But they needed us to demonstrate what additional work we were providing (‘GPs preparing legal challenges over PMS reviews').

We were quite reassured by this. However, the plug was then pulled with the trust cancelling its second practice visit. Subsequently the whole process was put on hold, even though we were told last year that the PMS review was a PCT priority and had to be complete by the end of the financial year.

I suspect this has come around through financial pressure and that the next phase, when it is rekindled, will be to impose cuts, which is what we initially feared. Our practice would face cuts of six figures so I am very encouraged to see a legal challenge is being pushed forward.

Surely the most efficient and straightforward way for PCTs to save money is to close walk-in centres, cancel Darzi contracts (both wasteful and not proven to do the job for which they were created) and cull some of the ridiculously complex layers of bureaucratic PCT management, who cost the NHS ridiculous sums of money with no obvious benefit at all.

Dr Daniel BurrowDarlington, North Yorkshire

Should 'wasteful' Darzi centres be closed before making cuts to PMS? Should 'wasteful' Darzi centres be closed before making cuts to PMS? Your letters